Cost Containment

Our audit team check all medical bills to ensure policyholders aren’t being overcharged, or subject to unnecessary procedures.

This specialist team is made up of auditors and doctors. They work together to make sure our insurance partners only pay for treatment and procedures that are:

required in an emergency

medically necessary

delivered at an appropriate cost

Initially doctors will examine medical reports to determine that treatment and diagnostic tests are necessary. These decisions are only made by medical clinicians – not accountants.

The audit team then looks at whether the bills reflects a reasonable charge for this treatment. This is done using objective benchmarks for medical treatment in the country where the claim originated.

These cost containment programmes have produced significant benefits:

Savings for insurers

Medical bills cut by 75% on average

Average ‘cost containment’ programme results in 60% saving

Better care for policyholders

Many cases of holidaymakers undergo unnecessary procedures abroad, or have treatment that could easily be carried out when they return home. This is never in the patient’s best interests, and can be distressing for those involved. Taking a tough stance on this can help reduce future incidents.

Our support for customers goes further. If we’ve declined to pay a medical bill we will continue to act as the policyholder’s representative so they are not harassed for payment by the medical facility.

Partnerships

If you are interested in finding out more about our Cost Containment Services please get in touch